Hungerbuhler P, Bovet P, Shamlaye C, Burnand B, Waeber B
Epidemiology and Research Unit, Ministry of Health, Victoria, Seychelles.
Bull World Health Organ. 1995;73(4):437-42.
Owing to increasing rates of hypertension and cardiovascular-related diseases in developing countries, compliance with antihypertensive medication is major public health importance. Few studies have reported on compliance in developing countries. We determined the compliance of 187 patients with uncontrolled hypertension in the Seychelles (Indian Ocean), by assessing the presence of a biologic marker (riboflavin) in the urine. The urine tested positive in 56% of the cases. Compliance varied from one physician to another (highest 72% versus lowest 33%, P = 0.003), improved with the level of literacy (62% versus 45%, P = 0.024), and depended on the presence absence of diuretics in the medication (respectively, 45% versus 66%, P = 0.005). The ability of patients to report correctly the number of antihypertensive pills to be taken daily was a predictor of compliance (62% of the patients who gave appropriate answers had positive urine for the marker versus 31% for those giving inappropriate answers).
由于发展中国家高血压和心血管相关疾病的发病率不断上升，抗高血压药物的依从性具有重大的公共卫生意义。很少有研究报道发展中国家的依从性情况。我们通过评估尿中生物标志物（核黄素）的存在情况，确定了塞舌尔（印度洋）187例高血压未得到控制患者的依从性。56%的病例尿液检测呈阳性。依从性因医生而异（最高72%，最低33%，P = 0.003），随着识字水平的提高而改善（62%对45%，P = 0.024），并且取决于药物中是否含有利尿剂（分别为45%对66%，P = 0.005）。患者正确报告每日应服用抗高血压药丸数量的能力是依从性的一个预测指标（给出正确答案的患者中有62%尿液中该标志物呈阳性，而给出错误答案的患者中这一比例为31%）。
